CARE HOME ADULTS 18-65
Pinewood & Hollywood Smiths Field Old Heath Colchester Essex CO1 2HP Lead Inspector
Jane Greaves Key Unannounced Inspection 31st October 2006 10:00 Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Pinewood & Hollywood Address Smiths Field Old Heath Colchester Essex CO1 2HP 01206 791455 01206 795971 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.rchl.org.uk Redbridge Community Housing Limited [RCHL] Mrs Patricia Marie Petrocochino Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 8 persons) Date of last inspection Brief Description of the Service: Pinewood and Hollywood is a care home providing personal care for 8 adults with learning disabilities. The home was opened in 1995, consists of two semidetached bungalows and is situated on a quiet residential development to the south of Colchester town centre close to local amenities. Each property has four single bedrooms, one bathroom, one shower room, a kitchen/dining room and a large communal lounge area. There is an enclosed garden to the rear of the property and ample car parking facilities to the front. The registered manager is Mrs. Patricia Petrocochino and the registered organisation is Redbridge Community Housing Limited (RCHL). Previous inspection reports issued by the Commission for Social Care Inspection were included within the home’s statement of purpose and service user guide. The fees charged for care and accommodation at Pinewood and Hollywood were £1234.21 per person as at 31.10.2006. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 31st October 2006. 21 of the 43 National Minimum Standards and the intended outcomes of these were assessed at this visit, 18 were met and one was exceeded. On this day three residents were away from the home enjoying an activity holiday, one resident was attending college, one was enjoying 1:1 time with specialist support provision, one resident was attending a dental appointment and two residents were at home for the day. There were no visitors to the home on this day and the residents remaining at the service did not have the ability to share their views of the service provision with the inspector. Subsequent to this site visit survey questionnaires were sent to the residents and their families in order to secure their confidential views of the care and facilities provided to the people living at Pinewood and Hollywood. The inspection process included discussion with the Registered Manager and the staff team. A sample of staff and residents’ records, supporting documentation and other records required to be kept in the home was studied together with direct and indirect observation. This report has been written using accumulated evidence gathered prior to and during the inspection. What the service does well: What has improved since the last inspection? What they could do better:
The registered manager should ensure that a scheduled staff-training programme is developed and adhered to encompassing all annual refresher training in the mandatory areas such as the Protection of Vulnerable Adults and basic food hygiene.
Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 6 The registered manager should ensure that documentary evidence to confirm the staff training that has been attended is available for scrutiny by the Commission for Social Care Inspection. The registered manager must ensure that evidence is available to confirm that all pre employment checks have been undertaken with satisfactory result. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents were only admitted to this service on the basis of a full assessment of their personal, physical, spiritual and social needs and being assured that these would be met. EVIDENCE: No new residents had been admitted to the home since the previous inspection site visit; policies and procedures for admitting new residents to the home remain as per detail contained within the previous inspection report for this service. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents could be confident that their assessed and changing needs and personal goals were reflected in their individual plan of support and care. EVIDENCE: There were support plans in place for each resident living at the home. Plans for two residents were sampled as part of this inspection site visit and were found to be comprehensive covering all aspects of the residents’ daily lives. The plans set out in detail goals for individuals and clear pathways to achieve these goals. Residents were involved with the development of their support plans where they were able and family involvement was evident for those residents with limited cognitive abilities. It was reported that the organisation was in the process of developing the support plans in a format more accessible and ‘user friendly’ for the residents. Evidence was available to confirm that regular support plan reviews took place and where residents’ needs were changing the reviews were more frequent as the needs dictated. Records
Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 10 confirmed that each resident had a designated key worker. The registered manager was able to report an instance where external advocacy services were secured for a resident with limited communication skills and cognitive awareness. The manager was able to demonstrate that some residents were supported to manage their own finances with support from their key workers. Residents were supported to take responsible risks within the risk management framework; one example of this was that 3 residents were away from the home on an activity holiday at the time of this site visit. Activities being undertaken and enjoyed included trampolining, horse riding and archery. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were treated with respect and dignity and supported to maintain appropriate, fulfilling and stimulating lifestyles in and outside the home. EVIDENCE: None of the residents living at Smithfields undertook paid work outside the home, however all residents living there enjoy an active and stimulating lifestyle. It was reported that 3 residents received support to maintain their finances independently. 2 residents were experiencing difficulties in physically accessing their bank in Colchester, the registered manager described the support provided for the residents to access more appropriate and suitable banking facilities ensuring their continued independence. Two residents had completed the Bronze Duke of Edinburgh award and one resident was undertaking the silver award. Activities undertaken towards this achievement included camping trips, train rides and attending art exhibitions.
Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 12 The staff and management team support residents to participate in local community life as part of everyday practice. Examples of community access and inclusion included personal shopping, use of the public library, using the local swimming pool for aqua aerobic sessions, going bowling and visiting the cinema. Records showed that individual’s shopping trips with key workers often resulted in a telephone call to the home to report that they wouldn’t be back for lunch as they had decided to eat in town. The manager reported, and records confirmed, that residents were very pro-active at the house meetings. There was no shortage of ideas for activities or outings that the residents wished to try and they were supported to achieve as many of their dreams as physically and financially possible. The residents were encouraged to invite their friends into the home with the agreement of their housemates and parties were a regular occurrence. The home is located in a residential area and the registered manager reported that the residents enjoyed an excellent relationship with the neighbours living in the vicinity. The families and representatives of the residents were encouraged to visit the home at any time of the day and were invited to events such as parties and barbecues. The daily routines at Pinewood and Hollywood were arranged solely around residents’ needs and preferences. Where residents had day centres or college courses to attend they were woken in good time to attend these however if there were no fixed plans for the day and a resident fancied a ‘lie in’ their wish was respected. Bed times varied around individuals’ preferences and lifestyles, it was reported that a resident would be advised if they had a busy day ahead of them and an early night was advisable however the final decision remained with the resident. Residents opened their own mail and staff read the contents to them providing explanations where necessary to provide the resident with the information required to decide how to respond if necessary. All residents undertook their own bedroom chores and laundry within their own capabilities. Mealtimes were flexible around the residents’ activities and lifestyles, food stocks were ample and of good quality. The registered manager reported that the four residents from the two individual houses chose the meals for the week ahead amongst themselves however, if on the day any resident did not fancy the selected meal an alternative of their choice would be provided. Records showed that some of the residents’ meal choices were adventurous. A picture book and recipe book were available to assist residents in making meal choices. Neither Pinewood or Hollywood house maintained accurate records of the residents’ daily food intake. A system was in place for this recording however records were found to be incomplete. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from the provision of appropriate personal and healthcare support. EVIDENCE: Residents’ support plans sampled at this inspection site visit contained good clear detail as to how individuals wished their personal care and support to be delivered. Examples of some information included in the support plans included individuals’ support requirements for washing and dressing, what food/medications/ activities were to be avoided, personal habits and routines, hobbies and interests, detail of healthcare appointments and outcomes of these, details of adult education classes attended and lists of each person’s ‘significant others’ with birthdates etc. Personal care and support was provided in private and by persons of the same gender. As mentioned previously in this report the times for going to bed and rising were flexible according the needs and wishes of individuals. Residents chose their own clothes and hairstyles in the main with family influence and support in some instances. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 14 Records were available to confirm that residents were provided with support to take control of their own healthcare within their abilities. The registered manager was able to provide detail of healthcare support accessed for one resident and how this person was supported and encouraged to take control and be pro-active with the issue. Support plans sampled contained evidence of annual health checks and specialist healthcare secured for residents when a need was identified. Three residents were able to sign their own support plans to confirm their involvement with the processes. Families/representatives signed to provide evidence of their involvement with the support plans of residents without the cognitive ability to be part of the care planning processes. The support plans were not in a format appropriate to this resident group and their cognitive abilities. The organisation was aware of this and it had been highlighted at a recent care audit. The registered manager reported that computer software was being secured to enable the service to produce documents in a user friendly format to enable more of the people living at Pinewood and Hollywood to be actively involved in the formulation and review of their individual support plans. Medications were stored appropriately in the two houses and Medication Administration Records were appropriately maintained with no gaps in recording. All staff had attended training in the Monitored Dosage System that had been certified for 3 years. RCHL medication policies stated that interim refresher training was provided for the staff members at the manager’s discretion and it was reported that a system of 3 monthly reviews of staff competence to safely administer medication was due to be implemented imminently. The registered manager was able to demonstrate that the service had various systems in place to double check the medication administration procedures to further ensure the health, safety and welfare of residents. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents could be confident their views would be listened to and taken seriously however they could not be as confident that they were protected from abuse. EVIDENCE: There had been no complaints received by the service or the Commission for Social Care Inspection since the previous inspection. Policies and procedures for dealing with complaints were contained within the Statement of Purpose and the Service Users Guide and both documents contained contact details for the Commission for Social Care Inspection. The service operated under the organisation’s robust policies and procedures for recruitment and it was reported that no staff member started to work at the service until two written references and a satisfactory enhanced Criminal Records Bureau disclosure (CRB) had been received. Recruitment documents were sampled for two staff members and both contained undertakings from RCHL human resources (HR) department that completed CRB disclosures had been received. These documents were developed to include the CRB reference number and to be signed by a representative of HR. One of these documents sampled at this visit did not include a CRB reference number and the document had not been signed to provide evidence that HR had received a satisfactory disclosure. The registered manager confirmed verbally that this disclosure had been received as the staff member had received their copy however there was no documentary evidence to confirm this. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 16 Staff training in the Protection of Vulnerable Adults had last been provided in September 2005 for the majority of the staff team. No annual refresher training had been attended and none had been scheduled at the point of this site visit. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in an environment that was appropriate for their lifestyle and needs. EVIDENCE: On the day of this inspection site visit both houses appeared clean bright, fresh and welcoming with no offensive odours present. The home was in good decorative order throughout and residents’ private rooms were personalised and decorated to their individual tastes. All staff had attended staff training in the control of infection in October 2005; the registered manager reported that an external refresher course was to be arranged in the immediate future. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff training and development were linked to the home’s aims and the residents’ needs however annual refresher training was not routinely provided. EVIDENCE: As mentioned earlier in this report the service operated under RCHL’s robust policies and procedures for the recruitment of staff members. Staff files sampled at this inspection contained all relevant documentation required to evidence that appropriate pre employment checks had been made with the exception of confirmation of CRB disclosure as detailed under standard 23. Evidence was available to confirm that residents were actively involved in staff selection and the staff interview processes. Staff received terms and conditions of employment and were subject to a probationary period with residents involved in the review. The service had developed a system to identify training requirements for the staff team as a whole and for individual team members. There were gaps in the mandatory refresher training provision such as the Protection of Vulnerable Adults and basic food hygiene. Documentary evidence was not available to
Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 19 confirm that refresher training had been attended for areas such as fire safety and first aid. Refresher training was booked for this month for safer people moving and handling. The service does provide specific training appropriate to the resident group and for areas such as equality and diversity. The registered manager reported difficulties in scheduling the mandatory training, the organisation’s training requirements and individuals’ personal developmental training requirements within budgetary restraints as well as maintaining appropriate staffing levels at the service. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefited from living in a well managed home. EVIDENCE: The registered manager had 3 ½ years experience in post and was also responsible for two further supported living projects. Evidence was available to confirm that the manager undertook regular training to maintain her skill levels and areas for personal development were identified at appraisal meetings. The manager’s qualifications to date include the Registered Manager’s Award, a diploma in management studies and a City and Guilds qualification “Advanced management in Care”. It was evident from observation that the management style was open and approachable and there were clear lines of accountability within the home. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 21 The service undertakes a quality assurance survey annually involving the residents, their families/representatives and outside stakeholders and this is due to be commenced this month. The registered manager confirmed that a summary will be prepared from the responses together with an action plan to address any identified shortfalls in the service provision and this will be forwarded to the Commission for Social Care Inspection upon completion. The registered manager reported that the organisation was currently reviewing all policies and procedures in line with changing legislation, it has been identified that a backlog had occurred and arrangements were in place to address this shortfall. Where changes in legislation occurred the organisation responded immediately producing guidelines for the service to follow and the policies were then reviewed and amended where necessary. The registered manager was able to demonstrate that health and safety checks were routinely undertaken and evidence was provided to confirm this. Fire drills took place at least twice a year; risk assessments were in place for those residents who may refuse to evacuate the building in the event of a fire. Window restrictors were fitted to residents’ bedroom windows and security lights were fitted to the outside of the premises. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA23 Regulation 13(6) Timescale for action The registered person shall make 31/01/07 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Thus specifically refers to the provision of annual refresher training in PoVA. 31/01/07 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform including structured induction training; and suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. This specifically refers to annual refresher training in all mandatory areas for the whole staff team. Requirement 2 YA35 18(1) (c) Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 YA34 Good Practice Recommendations It is a recommendation of good practice that the registered manager ensures records maintained within the care home relating to staff recruitment include evidence that enhanced CRB disclosures have been received. Pinewood & Hollywood DS0000017910.V318076.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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